Abstract

LAMELAS, Pablo M et al. Evaluation of the SYNTAX score by residents in clinical cardiology. Rev. argent. cardiol. [online]. 2012, vol.80, n.4, pp.299-303. ISSN 1850-3748.

Evaluation of the SYNTAX score by residents in clinical cardiology Background The SYNTAX score (SS) is a useful tool for selecting patients with left main or three-vessel coronary artery disease eligible for percutaneous coronary interventions. The score has moderate inter-observer reproducibility among members of the original study. There is not sufficient evidence about the evaluation of the SS by non-interventional cardiologists. Objectives To evaluate whether residents in cardiology can perform an adequate evaluation of the SS and to detect possible biases in this evaluation. Methods Coronary angiographies with evidence of main left coronary artery disease and/or three-vessel disease were retrospectively selected. A resident in cardiology (RC) calculated the total SS in order to compare it with the score calculated by an interventional cardiologist (IC). Data were analyzed using the kappa coefficient (deciles and tertiles), Lin's concordance correlation coefficient and Bland-Altman plot method. Results Ninety three coronary angiographies were analyzed. Mean SS calculated by the IC and the RC were 28.58 (SD 10.0) and 30.44 (SD 10.7), respectively. Mean difference was 1.85 (SD 7.01). The kappa coefficient was 0.57 (0.464-0.678) for deciles and 0.60 for tertiles (0.48-0.72). Lin's coefficient was 0.75 (0.65 to 0.83). The Bland-Altman analysis detected that the RC had a trend towards underestimating high scores calculated by the IC. Conclusions This study demonstrates a moderate to good inter-observer reproducibility between a RC and an IC. This level of agreement is tolerable to calculate the score, as previously published. A trend to underestimate high SS was detected in the RC.

Keywords : Angioplasty; Myocardial Revascularization; Coronary Artery Disease; Angiography.

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